MetLife Dental Benefits

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "MetLife Dental Benefits"

Transcription

1 NYU School of Medicine & NYU Hospitals Center Dental PPO Plus Plan Benefits For the savings you need, the flexibility you want and service you can trust. Benefit Summary Coverage Type PDP In-Network: Out-of-Network: Type A cleanings, oral examinations 100% of PDP Fee* 100% of R&C Fee** Type B fillings 80% of PDP Fee* 60% of R&C Fee** Type C bridges and dentures 60% of PDP Fee* 50% of R&C Fee** Type D orthodontia 50% of PDP Fee* 50% of R&C Fee** Deductible : In-Network Out-of-Network Individual $25 $50 Family $75 $150 Annual Maximum Benefit: Per Person $5,000 Orthodontia Lifetime Maximum: Per Person $2,000 * PDP Fee refers to the fees that participating PDP dentists have agreed to accept as payment in full, subject to any copayments, deductibles, cost sharing and benefits maximums. ** R&C fee refers to the Reasonable and Customary (R&C) charge, which is based on the lowest of (1) the dentist s actual charge, (2) the dentist s usual charge for the same or similar services, or (3) the charge of most dentists in the same geographic area for the same or similar services as determined by MetLife. Applies only to type B & C Services. PDP Savings Example This hypothetical example* shows how receiving services from a PDP (in-network) dentist can save you money. *Please note: This example assumes that your annual deductible has been met. Your Dentist says you need a Crown, a Type C service PDP Fee: $ R&C Fee $ Dentist s Usual Fee: $ IN-NETWORK When you receive care from a participating PDP dentist: OUT-OF-NETWORK When you receive care from a non-participating dentist: Dentist s Usual Fee is: $ Dentist s Usual Fee is: $ The PDP Fee is: $ Your Plan Pays: Your Plan Pays: 60% X $375 PDP Fee - $ % X $500 R&C Fee - $ Your Out-of-Pocket Cost: $ Your Out-of-Pocket Cost: $ In this example, you save $ ($ minus $150.00) by using a participating PDP dentist.

2 List of Primary Covered Services & Limitations Type A - Preventive Prophylaxis (cleanings) Oral Examinations Topical Fluoride Applications X-rays Space Maintainers Sealants Type B - Basic Restorative Fillings Simple Extractions Crown, Denture, and Bridge Repair/Recementations Endodontics General Anesthesia Oral Surgery Periodontics Type C - Major Restorative Bridges and Dentures Crowns/Inlays/Onlays Implants Two per calendar year. Two exams per calendar year. One fluoride treatment per calendar year for dependent children up to their 19 th birthday. Full mouth X-rays: one per 36 months. Bitewing X-rays: two sets per calendar year for adults and children. Space Maintainers for dependent children up to 19th birthday. One application of sealant material every 3 years for each non-restored, non-decayed 1st and 2 nd molar of a dependent child up to 19th birthday. Root canal treatment limited to once per tooth per 24 months. When dentally necessary in connection with oral surgery, extractions or other covered dental services. Periodontal scaling and root planing once per quadrant, every 24 months. Periodontal surgery once per quadrant, every 24 months. Total number of periodontal maintenance treatments and prophylaxis cannot exceed four treatments in a calendar year. Initial placement to replace one or more natural teeth, which are lost while covered by the Plan. Dentures and bridgework replacement: one every 5 years. Replacement of an existing temporary full denture if the temporary denture cannot be repaired and the permanent denture is installed within 12 months after the temporary denture was installed. Replacement: once every 5 years. Implant supported prosthetics but not more than once for the same tooth position in a 5 year period. Replacement: once every 5 years. Repair of implants, but no more than once in a 12 month period. Type D - Orthodontia You and Your Spouse are covered. Your Children are covered until the end of the year of their 19 th birthday or the end of the semester of their 25 th birthday if un-married full-time students. All dental procedures performed in connection with orthodontic treatment are payable as Orthodontia. Payments are on a repetitive basis. Benefit for initial placement of the appliance will be made representing 20% of the total benefit. Orthodontic benefits end at cancellation of coverage (0908)

3 Common Questions Important Answers Who is a participating Preferred Dentist Program (PDP) dentist? A participating dentist is a general dentist or specialist who has agreed to accept MetLife s negotiated fees as payment in-full for services provided to plan participants. PDP fees typically range from 10-35% below the average fees charged in a dentist s community for the same or substantially similar services. Based on internal analysis by MetLife How do I find a participating PDP dentist? There are nearly 115,000 participating PDP dentist locations nationwide, including over 27,000 specialist locations. You can get a list of these participating PDP dentists online at or call to have a list faxed or mailed to you. What services are covered by my plan? All services defined under your group dental benefits plan are covered. Please review the enclosed plan benefits to learn more. Does the Preferred Dentist Program (PDP) offer any discounts on non-covered services? Yes. MetLife s negotiated fees with PDP (in-network) dentists extend to services not covered under your plan and services received after your plan maximum has been met. If you receive services from a PDP dentist that are not covered under your plan, you are only responsible for the PDP (in-network) fee. May I choose a non-participating dentist? Yes. You are always free to select the dentist of your choice. However, if you choose a dentist who does not participate in the MetLife PDP, your out-of-pocket expenses may be more, since you will be responsible to pay for any difference between the dentist s fee and your plan s payment for the approved service. If you receive services from a participating PDP dentist, you are only responsible for the difference between the PDP in-network fee for the service provided and your plan s payment for the approved service. Please note: any plan deductibles must be met before benefits are paid. Can my dentist apply for PDP participation? Yes. If your current dentist does not participate in the PDP and you'd like to encourage him or her to apply, tell your dentist to visit or call MET-DDS9 for an application. The website and phone number are designed for use by dental professionals only. How are claims processed? Dentists may submit your claims for you which means you have little or no paperwork. You can track your claims online and even receive alerts when a claim has been processed. If you need a claim form, you can find one online at or request one by calling Can I find out what my out-of-pocket expenses will be before receiving a service? Yes. With pre-treatment estimates, you never have to wonder what your out-of-pocket expense will be. MetLife recommends that you request a pre-treatment estimate for services in excess of $300 (This often applies to services such as crowns, bridges, inlays, and periodontics.) To receive a benefit estimate, simply have your dentist submit a request for pretreatment estimate online at or call MET-DDS9 ( ). You and your dentist will receive a benefit estimate (online or by fax) for most procedures while you re still in the office, so you can discuss treatment and payment options, and have the procedure scheduled on the spot. Actual payments may vary depending upon plan maximums, deductibles, frequency limits and other conditions at time of payment.

4 Exclusions This plan does not cover the following services, treatments and supplies: Services which are not Dentally Necessary, those which do not meet generally accepted standards of care for treating the particular dental condition, or which we deem experimental in nature; Services for which you would not be required to pay in the absence of Dental Insurance; Services or supplies received by you or your Dependent before the Dental Insurance starts for that person; Services which are primarily cosmetic (for Texas residents, see notice page section in Certificate); Services which are neither performed nor prescribed by a Dentist except for those services of a licensed dental hygienist which are supervised and billed by a Dentist and which are for: Scaling and polishing of teeth; or Fluoride treatments; Services or appliances which restore or alter occlusion or vertical dimension; Restoration of tooth structure damaged by attrition, abrasion or erosion; Restorations or appliances used for the purpose of periodontal splinting; Counseling or instruction about oral hygiene, plaque control, nutrition and tobacco; Personal supplies or devices including, but not limited to: water picks, toothbrushes, or dental floss; Decoration, personalization or inscription of any tooth, device, appliance, crown or other dental work; Missed appointments; Services: Covered under any workers compensation or occupational disease law; Covered under any employer liability law; For which the employer of the person receiving such services is not required to pay; or Received at a facility maintained by the Employer, labor union, mutual benefit association, or VA hospital; Services covered under other coverage provided by the Employer; Temporary or provisional restorations; Temporary or provisional appliances; Prescription drugs; Services for which the submitted documentation indicates a poor prognosis; The following when charged by the Dentist on a separate basis: Claim form completion; Infection control such as gloves, masks, and sterilization of supplies; or Local anesthesia, non-intravenous conscious sedation or analgesia such as nitrous oxide. Dental services arising out of accidental injury to the teeth and supporting structures, except for injuries to the teeth due to chewing or biting of food; Caries susceptibility tests; Initial installation of a fixed and permanent Denture to replace one or more natural teeth which were missing before such person was insured for Dental Insurance, except for congenitally missing natural teeth; Other fixed Denture prosthetic services not described elsewhere in the certificate; Precision attachments, except when the precision attachment is related to implant prosthetics; Initial installation or replacement of a full or removable Denture to replace one or more natural teeth which were missing before such person was insured for Dental Insurance, except for congenitally missing natural teeth; Addition of teeth to a partial removable Denture to replace one or more natural teeth which were missing before such person was insured for Dental Insurance, except for congenitally missing natural teeth; Adjustment of a Denture made within 6 months after installation by the same Dentist who installed it; Repair or replacement of an orthodontic device; Duplicate prosthetic devices or appliances; Replacement of a lost or stolen appliance, Cast Restoration, or Denture; and Intra and extraoral photographic images (0908)

5 Alternate Benefits: Your dental plan provides that where two or more professionally acceptable dental treatments for a dental condition exist, your plan bases reimbursement, and the associated procedure charge, on the least costly treatment alternative. If you and your dentist have agreed on a treatment which is more costly than the treatment upon which the plan benefit is based, your actual out-of-pocket expense will be: the procedure charge for the treatment upon which the plan benefit is based, plus the full difference in cost between the scheduled PDP fee or, if non PDP, the actual charge, for the service actually rendered and the scheduled PDP fee or R&C fee (if non PDP) for the service upon which the plan benefit is based. To avoid any misunderstandings, we suggest you discuss treatment options with your dentist before services are rendered, and obtain a pre-treatment estimate of benefits prior to receiving certain high cost services such as crowns, bridges or dentures. You and your dentist will each receive an Explanation of Benefits (EOB) outlining the services provided, your plans reimbursement for those services, and your out-of-pocket expense. Procedure charge schedules are subject to change each plan year. You can obtain an updated procedure charge schedule for your area via fax by calling and using the MetLife Dental Automated Information Service. Cancellation/Termination of Benefits: Coverage is provided under a group insurance policy (Policy form G.2130-S) issued by MetLife. Coverage terminates when your membership ceases, when your dental contributions cease or upon termination of the group policy by the Policyholder or MetLife. The group policy terminates for non-payment of premium and may terminate if participation requirements are not met or if the Policyholder fails to perform any obligations under the policy. The following services that are in progress while coverage is in effect will be paid after the coverage ends, if the applicable installment or the treatment is finished within 31 days after individual termination of coverage: Completion of a prosthetic device, crown or root canal therapy. Like most group health insurance policies, MetLife group policies contain certain exclusions, limitations, waiting periods and terms for keeping them in force. Please contact MetLife for complete details. L (exp1209)(All States)(DC,GU,MP,PR,VI)

District School Board of Pasco County PPO Dental Plan Benefits

District School Board of Pasco County PPO Dental Plan Benefits District School Board of Pasco County PPO Dental Plan Benefits For the savings you need, the flexibility you want and service you can trust. Benefit Summary Core PPO Plan Voluntary (Opt-Out) PPO Plan Coverage

More information

Elkhart Community Schools Dental Plan Benefits

Elkhart Community Schools Dental Plan Benefits Elkhart Community Schools Dental Plan Benefits Network: PDP Plus Benefit Summary Coverage Type In-Network Out-of-Network Type A cleanings, oral examinations 80% of Negotiated Fee* 80% of R&C Fee** Type

More information

Mills College - Student Dental Plan Benefits

Mills College - Student Dental Plan Benefits Mills College - Student Dental Plan Benefits For the savings you need, the flexibility you want and service you can trust. Benefit Summary Coverage Type PDP In-Network: Out-of-Network: Type A cleanings,

More information

Bendix Commercial Vehicle Systems, LLC Dental Plan Benefits

Bendix Commercial Vehicle Systems, LLC Dental Plan Benefits Bendix Commercial Vehicle Systems, LLC Dental Plan Benefits Preferred Plan For the savings you need, the flexibility you want and service you can trust. Benefit Summary Coverage Type PDP In-Network Out-of-Network

More information

Trustees of the Board of Higher Education / Massachusetts Teachers Association Dental Plan Benefits

Trustees of the Board of Higher Education / Massachusetts Teachers Association Dental Plan Benefits Trustees of the Board of Higher Education / Massachusetts Teachers Association Dental Plan Benefits For the savings you need, the flexibility you want and service you can trust. Benefit Summary Coverage

More information

Olentangy Local School District Dental Plan Benefits

Olentangy Local School District Dental Plan Benefits Olentangy Local School District Dental Plan Benefits For the savings you need, the flexibility you want and service you can trust. Benefit Summary Coverage Type PDP In-Network Out-of-Network Type A cleanings,

More information

Commander Navy Installation Command (CNIC) Dental Plan Benefits

Commander Navy Installation Command (CNIC) Dental Plan Benefits Commander Navy Installation Command (CNIC) Dental Plan Benefits For the savings you need, the flexibility you want and service you can trust. Benefit Summary Coverage Type PDP In-Network: Out-of-Network:

More information

Engility Corporation Dental Plan Benefits

Engility Corporation Dental Plan Benefits Engility Corporation Dental Plan Benefits Network: PDP Plus Benefit Summary Coverage Type In-Network Out-of-Network Type A cleanings, oral examinations 100% of Negotiated Fee* 100% of R&C Fee** Type B

More information

Bendix Commercial Vehicle Systems, LLC. Dental Plan Benefits

Bendix Commercial Vehicle Systems, LLC. Dental Plan Benefits Bendix Commercial Vehicle Systems, LLC. Dental Plan Benefits Preferred Plus Plan For the savings you need, the flexibility you want and service you can trust. Benefit Summary Coverage Type PDP In-Network

More information

Scott & White Dental Plan Benefits

Scott & White Dental Plan Benefits Scott & White Dental Plan Benefits For the savings you need, the flexibility you want and service you can trust. Benefit Summary Select Plan Enhanced Plan Coverage Type PDP : : Coverage Type PDP : : Type

More information

Ingredion Incorporated PPO Dental Plan Benefits

Ingredion Incorporated PPO Dental Plan Benefits Ingredion Incorporated PPO Dental Plan Benefits For the savings you need, the flexibility you want and service you can trust. Benefit Summary Coverage Type PDP In-Network Out-of-Network (based on the 90

More information

Boy Scouts of America Dental Plan Benefits

Boy Scouts of America Dental Plan Benefits Boy Scouts of America Dental Plan Benefits For the savings you need, the flexibility you want and service you can trust. Network: PDP Benefit Summary Coverage Type PDP In-Network Out-of-Network Type A

More information

Worthington City Schools Dental Plan Benefits

Worthington City Schools Dental Plan Benefits Worthington City Schools Dental Plan Benefits For the savings you need, the flexibility you want and service you can trust. Network: PDP Plus Benefit Summary Coverage Type PDP In-Network Out-of-Network

More information

Hood College Dental Plan Benefits

Hood College Dental Plan Benefits Hood College Dental Plan Benefits For the savings you need, the flexibility you want and service you can trust. Benefit Summary Plan Option 1 Hood College Standard Plan Plan Option 2 Hood College High

More information

The Claremont Colleges Dental Plan Benefits

The Claremont Colleges Dental Plan Benefits The Claremont Colleges Dental Plan Benefits Network: PDP Plus Benefit Summary Coverage Type In-Network Out-of-Network Type A cleanings, oral examinations 100% of Negotiated Fee* 90% of R&C Fee** Type B

More information

Clay County Board of County Commissioners Dental Plan Benefits

Clay County Board of County Commissioners Dental Plan Benefits Clay County Board of County Commissioners Dental Plan Benefits Network: PDP PlusBenefit Summary Plan Option 1 Low Plan Plan Option 2 High Plan Coverage Type Coverage Type Type A cleanings, oral examinations

More information

Paulding County School District Dental Plan Benefits

Paulding County School District Dental Plan Benefits Paulding County School District Dental Plan Benefits Network: PDP Plus Benefit Summary Plan Option 1 High Plan Plan Option 2 Low Plan Coverage Type In-Network Out-of-Network Coverage Type In-Network Out-of-Network

More information

Richmond County Board of Education Dental Plan Benefits January 1, 2016 through December 31, 2016

Richmond County Board of Education Dental Plan Benefits January 1, 2016 through December 31, 2016 Richmond County Board of Education Dental Plan Benefits January 1, 2016 through December 31, 2016 Network: PDP Plus Benefit Summary Option 1 High Plan Option 2 Low Plan Coverage Type Coverage Type Type

More information

DHE Non-Unit Employee Health and Welfare Fund Dental Plan Benefits

DHE Non-Unit Employee Health and Welfare Fund Dental Plan Benefits DHE Non-Unit Employee Health and Welfare Fund Dental Plan Benefits Network: PDP Plus Benefit Summary Coverage Type In-Network Out-of-Network Type A cleanings, oral examinations 100% of Negotiated Fee*

More information

Liberty Healthcare Management, Inc. Dental Plan Benefits

Liberty Healthcare Management, Inc. Dental Plan Benefits Liberty Healthcare Management, Inc. Dental Plan Benefits Network: PDP Plus Benefit Summary Coverage Type In-Network Out-of-Network Type A cleanings, oral examinations 100% of Negotiated Fee* 100% of R&C

More information

IMPORTANT CARRIER INFORMATION

IMPORTANT CARRIER INFORMATION Anchorage School District Dental Plan Benefits Network: PDP Plus Benefit Summary Coverage Type In-Network Out-of-Network Type A cleanings, oral examinations 100% of Negotiated Fee* 100% of R&C Fee** Type

More information

Mills College Student Health Plan - Dental Plan Benefits

Mills College Student Health Plan - Dental Plan Benefits Mills College Student Health Plan - Dental Plan Benefits Network: PDP Plus Benefit Summary Coverage Type In-Network Out-of-Network Type A cleanings, oral examinations 100% of Negotiated Fee* 80% of R&C

More information

The University of Alabama at Birmingham Dental Plan Benefits

The University of Alabama at Birmingham Dental Plan Benefits The University of Alabama at Birmingham Dental Plan Benefits Network: PDP Plus Benefit Summary Basic Plan Plan Option 1 Benefit Summary Coverage Type In-Network Out-of-Network Type A cleanings, oral examinations

More information

Princeton University Dental Plan Benefits

Princeton University Dental Plan Benefits Princeton University Dental Plan Benefits For the savings you need, the flexibility you want and service you can trust. Network: PDP Plus Benefit Summary Plan Option 1 Basic Option PPO Plan Plan Option

More information

MetLife Group Dental Insurance

MetLife Group Dental Insurance The University of Alabama at Birmingham Dental Plan Benefits For the savings you need, the flexibility you want and service you can trust. Comprehensive Plan Plan Option 2 Benefit Summary Coverage Type

More information

Atlanta Public Schools Dental Plan Benefits

Atlanta Public Schools Dental Plan Benefits Atlanta Public Schools Dental Plan Benefits Network: PDP Plus Benefit Summary Base Plan Coverage Type In-Network Out-of-Network Type A cleanings, oral examinations 100% of Negotiated Fee* 100% of Negotiated

More information

Low Plan. High Plan Coverage Type

Low Plan. High Plan Coverage Type Dental Benefits Savings, flexibility and service. For healthier smiles. Overview of Benefits for: Earlham College With all of the emphasis on healthy living, it may be refreshing to know you have access

More information

CALIFORNIA ASSOCIATION OF REALTORS

CALIFORNIA ASSOCIATION OF REALTORS CALIFORNIA ASSOCIATION OF REALTORS Summary of Benefits MetLife Dental Insurance Plan benefits effective 1/1/16 BENEFITS Plans at a glance CHOICE PLAN SELECT PLAN VALUE PLAN Reimbursement In-Network Out-of-

More information

Coverage Type: Fee 2 Type A - Preventive 100% 100% 100% 100% Type B - Basic Restorative. 50% 50% 40% 40% Type D Orthodontia 50% 50% NA NA

Coverage Type: Fee 2 Type A - Preventive 100% 100% 100% 100% Type B - Basic Restorative. 50% 50% 40% 40% Type D Orthodontia 50% 50% NA NA Dental Plan Design for: Town of Burlington Original Plan Effective Date: January 1, 2016 Network: PDP Plus The Preferred Dentist Program was designed to help you get the dental care you need and help lower

More information

In-Network % of PDP Fee. Applies to Type B & C services only

In-Network % of PDP Fee. Applies to Type B & C services only Dental Benefits Savings, flexibility and service. For healthier smiles. Overview of Benefits for: WMBE Payrolling Inc Original Plan Effective Date: 07/01/2013 With all of the emphasis on healthy living,

More information

Your Dentist says you need a Crown, a Type C Service** Dentist s Usual Fee: $600.00 - R&C Fee: $500.00 - PDP Fee: $375.00

Your Dentist says you need a Crown, a Type C Service** Dentist s Usual Fee: $600.00 - R&C Fee: $500.00 - PDP Fee: $375.00 To help you enroll, the following pages outline your company s dental plan 1 and address any questions you may have. Coverage Type In-Network 2 Out-of-Network 2 Type A - Preventive 100% of PDP Fee 3 80%

More information

Waco Independent School District Dental Plan Benefits

Waco Independent School District Dental Plan Benefits Waco Independent School District Dental Plan Benefits For the savings you need, the flexibility you want and service you can trust. Benefit Summary Coverage Type PDP In-Network Out-of-Network Type A cleanings,

More information

Mature Decisions Dental Coverage Type In-Network Out-of-Network Type A cleanings, oral examinations

Mature Decisions Dental Coverage Type In-Network Out-of-Network Type A cleanings, oral examinations Dental Plan Summary Network: PDP/PDP Plus Mature Decisions Dental Coverage Type In-Network Out-of-Network Type A cleanings, oral examinations 100% of Negotiated Fee* 100% of Negotiated Fee* Type B fillings

More information

Choice, Service, Savings. To help you enroll, the following pages outline your company's dental plan and address any questions you may have.

Choice, Service, Savings. To help you enroll, the following pages outline your company's dental plan and address any questions you may have. Plan Design for: Unitarian Universalist Association of Congregations Effective Date: October 01, 2002 Amendment Effective Date ± : January 01, 2013 Date Prepared: January 01, 2015 Choice, Service, Savings.

More information

OVERVIEW The MetLife Dental Plan for Retirees

OVERVIEW The MetLife Dental Plan for Retirees OVERVIEW The MetLife Dental Plan for Retirees IN NETWORK: Staying in network saves you money. 1 Participating dentists have agreed to MetLife s negotiated fees which are typically 15% to 45% below the

More information

Why Choose ASCE Group Dental Insurance?

Why Choose ASCE Group Dental Insurance? Maintaining a healthy smile is important to your overall health, but regular trips to the dentist can be costly. ASCE Group Dental Insurance helps keep your budget in check. Our plan covers both preventive

More information

USI Affinity Dental Plan Benefits

USI Affinity Dental Plan Benefits USI Affinity Dental Plan Benefits : PDP Plus Benefit Summary Platinum Gold Silver Coverage Type In- In- In- Type A Preventive R&C * Type B Basic 80% of 80% of R&C * 70% of 70% of Type C Major R&C * 40%

More information

Arkansas State Employees Association & MetLife

Arkansas State Employees Association & MetLife Arkansas State Employees Association & MetLife Are Pleased to Offer Dental Benefits to Participating Members To enroll, please complete and return the enrollment form to ASEA in the enclosed return envelope.

More information

USI Affinity Dental Plan Benefits

USI Affinity Dental Plan Benefits USI Affinity Dental Plan Benefits : PDP Plus Benefit Summary Platinum Gold Silver Coverage Type In- In- In- Type A Preventive R&C * Type B Basic 80% of 80% of R&C * 70% of 70% of Type C Major R&C * 40%

More information

DENTAL INSURANCE A DESCRIPTION OF BENEFITS FOR EMPLOYER MEMBERS OF THE MICHIGAN MANUFACTURERS ASSOCIATION FEATURES

DENTAL INSURANCE A DESCRIPTION OF BENEFITS FOR EMPLOYER MEMBERS OF THE MICHIGAN MANUFACTURERS ASSOCIATION FEATURES DENTAL INSURANCE A DESCRIPTION OF BENEFITS FOR EMPLOYER MEMBERS OF THE MICHIGAN MANUFACTURERS ASSOCIATION Michigan Manufacturers Association FEATURES PREFERRED DENTIST PROGRAM MetLife s nationwide network

More information

You may receive dental services from any dentist practicing within the scope of his or her license.

You may receive dental services from any dentist practicing within the scope of his or her license. DENTAL PLAN Once you enroll in one of the Getty s medical plans, you and your covered dependents are automatically enrolled in the Dental Plan. The Dental Plan, which is offered through MetLife, allows

More information

Dental Benefits. A healthy smile could mean. better health that s why. I need a good dental plan.

Dental Benefits. A healthy smile could mean. better health that s why. I need a good dental plan. Group Dental Dental Benefits Savings, flexibility and service. For healthier smiles. A healthy smile could mean better health that s why I need a good dental plan. Regular visits to the dentist may do

More information

Mature Decisions Dental Coverage Type In-Network Out-of-Network Type A cleanings, oral examinations

Mature Decisions Dental Coverage Type In-Network Out-of-Network Type A cleanings, oral examinations Dental Plan Summary Network: PDP/PDP Plus Mature Decisions Dental Coverage Type In-Network Out-of-Network Type A cleanings, oral examinations 100% of Negotiated Fee* 100% of Negotiated Fee* Type B fillings

More information

Dental Benefits. If better health can begin. City of Jacksonville Silver, Gold & Platinum Plans. Dental Benefits Information for:

Dental Benefits. If better health can begin. City of Jacksonville Silver, Gold & Platinum Plans. Dental Benefits Information for: Group Dental Dental Benefits Savings, flexibility and service. For healthier smiles. If better health can begin with a healthy smile, a good dental plan is what I need. Dental Benefits Information for:

More information

Delta Dental Individual and Family Dental Plans. EHB Certified DELTA DENTAL OF NORTH CAROLINA

Delta Dental Individual and Family Dental Plans. EHB Certified DELTA DENTAL OF NORTH CAROLINA Delta Dental Individual and Family Dental Plans EHB Certified DELTA DENTAL OF NORTH CAROLINA You ll benefit from: Freedom Enjoy access to two Delta Dental networks Delta Dental PPO and Delta Dental Premier.

More information

Good news about dental benefits for employees of NORTHWEST FLORIDA STATE COLLEGE

Good news about dental benefits for employees of NORTHWEST FLORIDA STATE COLLEGE Voluntary Dental PPO (BASIC PLAN) Good news about dental benefits for employees of Your Dental Plan As a valued employee of, you have the opportunity to enroll in a payroll-deduction dental program. Plan

More information

MetLife PPO Dental Plan

MetLife PPO Dental Plan MetLife PPO Dental Plan Target CW is pleased to offer you participation in MetLife Dental Plan. Below is some important information to know about the plan. If you have any questions, please do not hesitate

More information

2016 Group Dental Member Handbook. For active employees and retirees BENEFITS. State of Tennessee

2016 Group Dental Member Handbook. For active employees and retirees BENEFITS. State of Tennessee 2016 Group Dental Member Handbook For active employees and retirees BENEFITS State of Tennessee Revised on 4/19/2016 Welcome! Why is having a good Dental plan so important? Because a healthier smile can

More information

2014 Evidence of Coverage Optional Supplemental Benefits Attachment Coventry Medicare Advantage Dental Plan (PPO)

2014 Evidence of Coverage Optional Supplemental Benefits Attachment Coventry Medicare Advantage Dental Plan (PPO) 2014 Evidence of Coverage Optional Supplemental Benefits Attachment OPTIONAL SUPPLEMENTAL BENEFITS YOU CAN BUY As explained in Chapter 4, Section 2.2 of this Evidence of Coverage, our plan offers some

More information

Dental Benefits. How Dental Benefits Work. Schedule of Benefits

Dental Benefits. How Dental Benefits Work. Schedule of Benefits Dental coverage under Stryker s healthcare plan helps pay dental bills for you and your family. It is designed to encourage good dental care. The plan covers preventive dental services and treatment for

More information

FREEDOM THE. What s Inside

FREEDOM THE. What s Inside YOUR DENTAL PLAN THE FREEDOM As a member of the MILA National Health Plan, you are eligible to receive comprehensive dental benefits, administered by Aetna, beginning January 1, 2011. What s Inside Page

More information

Dental Outline of Coverage

Dental Outline of Coverage Dental Outline of Coverage Blue Cross and Blue Shield of Texas (herein called (BCBSTX, We, Us, Our) Dental Indemnity Insurance Contract REQUIRED OUTLINE OF COVERAGE A. Read Your Contract Carefully. This

More information

Dental Provider e-manual - 2014 Updates NEW DENTAL INFORMATION for 2014

Dental Provider e-manual - 2014 Updates NEW DENTAL INFORMATION for 2014 Dental Provider e-manual - 2014 Updates NEW DENTAL INFORMATION for 2014 Pediatric Oral Health Effective, January 1, 2014, the Affordable Care Act (ACA) mandate makes available Pediatric Oral Health benefits

More information

OPTION #2 COMPANION LIFE DENTAL INSURANCE PLAN SELECT ANY DENTIST

OPTION #2 COMPANION LIFE DENTAL INSURANCE PLAN SELECT ANY DENTIST OPTION #2 COMPANION LIFE DENTAL INSURANCE PLAN SELECT ANY DENTIST A Dental Plan for Groups of Three or More Covered Services Description SELECT ANY DENTIST Preventive, Basic, and Major services are subject

More information

An Overview of Your Dental Benefits

An Overview of Your Dental Benefits An Overview of Your Dental Benefits Educators Health Alliance ii \ DENTAL BENEFITS PPO Dental Plan Options OPTION 1 Maintenance Dentistry OPTION 2 (STANDARD PLAN) IN-NETWORK OUT-OF-NETWORK Maintenance

More information

2007 Insurance Benefits Guide. Dental and Dental Plus. Dental and. Dental Plus. www.eip.sc.gov Employee Insurance Program 91

2007 Insurance Benefits Guide. Dental and Dental Plus. Dental and. Dental Plus. www.eip.sc.gov Employee Insurance Program 91 Dental and www.eip.sc.gov Employee Insurance Program 91 Table of Contents Introduction...93 Your Dental Benefits at a Glance...94 Claim Examples (using Class III procedure claims)...95 How to File a Dental

More information

A DENTAL PLAN THAT BALANCES CHOICE & SAVINGS

A DENTAL PLAN THAT BALANCES CHOICE & SAVINGS A DENTAL PLAN THAT BALANCES CHOICE & SAVINGS GuideStone s Choice Dental Plan Cigna Total DPPO The Cigna Total Dental PPO (DPPO) network makes it easy to protect your health and your smile with the right

More information

Dental Plan General Information

Dental Plan General Information Dental Plan General Information CSU offers two dental plans for employees to choose from: Delta Dental Basic and Delta Dental Plus. Both plans are self-insured and administered, including claims processing,

More information

FORD DENTAL COVERAGE

FORD DENTAL COVERAGE FORD DENTAL COVERAGE HOW DENTAL COVERAGE WORKS The Trust provides dental coverage to you and your eligible Dependents. A Dental Benefits Manager, Delta Dental of Michigan, whose contact information is

More information

DENTAL FOR EVERYONE SUMMARY OF BENEFITS, LIMITATIONS AND EXCLUSIONS

DENTAL FOR EVERYONE SUMMARY OF BENEFITS, LIMITATIONS AND EXCLUSIONS DENTAL FOR EVERYONE SUMMARY OF BENEFITS, LIMITATIONS AND EXCLUSIONS DEDUCTIBLE The dental plan features a deductible. This is an amount the Enrollee must pay out-of-pocket before Benefits are paid. The

More information

METLIFE IMPORTANT BENEFITS INFORMATION VETERANS AFFAIRS DENTAL INSURANCE PROGRAM (VADIP)

METLIFE IMPORTANT BENEFITS INFORMATION VETERANS AFFAIRS DENTAL INSURANCE PROGRAM (VADIP) WHO IS ELIGIBLE FOR BENEFITS? This Government dental benefit program helps protect the smiles of Veterans and their families by offering them comprehensive dental coverage. With VADIP there are two plan

More information

Dental Benefits. If I want to be at my best, a good dental plan. will be refreshing. Savings, flexibility and service. For healthier smiles.

Dental Benefits. If I want to be at my best, a good dental plan. will be refreshing. Savings, flexibility and service. For healthier smiles. Group Dental Dental Benefits Savings, flexibility and service. For healthier smiles. If I want to be at my best, a good dental plan will be refreshing. A lot of emphasis has been put on healthy living

More information

2014 Evidence of Coverage Optional Supplemental Benefits Attachment Coventry Medicare Advantage Dental Plan (HMO)

2014 Evidence of Coverage Optional Supplemental Benefits Attachment Coventry Medicare Advantage Dental Plan (HMO) 2014 Evidence of Coverage Optional Supplemental Benefits Attachment OPTIONAL SUPPLEMENTAL BENEFITS YOU CAN BUY As explained in Chapter 4, Section 2.2 of this Evidence of Coverage, our plan offers some

More information

Dental Benefits Summary Active PPO With PPOII Network

Dental Benefits Summary Active PPO With PPOII Network Aetna Dental Plan Dental Benefits Summary With PPOII Network Participating Non-participating Annual Deductible* Individual $100 $125 Family $300 $375 Preventive Services 100% 80% Basic Services 80% 70%

More information

Dental Plans YOUR GUARDIAN PLAN OFFERS:

Dental Plans YOUR GUARDIAN PLAN OFFERS: Dental Plans Option 1 or 2: With your High Plan or Low Plan plan, you can visit any dentist; but you pay less out-of-pocket when you choose a PPO dentist. COMPARE THE PLANS Option 1: High Plan Option 2:

More information

Uniform Dental Benefits: State Participants 2015

Uniform Dental Benefits: State Participants 2015 Uniform Dental Benefits (Certificate of Coverage) Please read the following information carefully for Your procedure frequencies and provisions. All dental benefits are paid according to the terms of the

More information

IN THIS SECTION SEE PAGE. For More Information. Diageo: Your 2015 Employee Benefits 73

IN THIS SECTION SEE PAGE. For More Information. Diageo: Your 2015 Employee Benefits 73 Diageo: Your 2015 Employee Benefits 73 Dental Plan Good dental habits are an important part of safeguarding your general health, and can also help you reduce dental bills. Diageo NA s dental coverage,

More information

P. O. Box 3283 Tulsa, OK For Subscribers Age 21 and Over

P. O. Box 3283 Tulsa, OK For Subscribers Age 21 and Over P. O. Box 3283 Tulsa, OK 74102-3283 BLUECARE DENTAL 1A OUTLINE OF COVERAGE Read your Contract carefully This outline coverage provides only a very brief description the important features your Contract.

More information

Quality, affordable dental insurance

Quality, affordable dental insurance Quality, affordable dental insurance Group association dental insurance under the IHC Dental plans is underwritten by Madison National Life Insurance Company, Inc. For residents of Texas. Your oral health

More information

Quality, affordable dental insurance

Quality, affordable dental insurance Quality, affordable dental insurance Group association dental insurance under the IHC Dental plans is underwritten by Madison National Life Insurance Company, Inc. in all states except Maine, New Hampshire

More information

WMI Mutual Insurance Company

WMI Mutual Insurance Company Dental Policy WMI Mutual Insurance Company PO Box 572450 Salt Lake City, UT 84157 (801) 263-8000 & (800) 748-5340 Fax: (801) 263-1247 DENTAL POLICY A. Schedule of Benefits: Annual Maximum Dental Benefit

More information

Performance Plus Dental Plan. Annual Deductible. Dental Benefit Maximums. Prior Authorization. Verification of Coverage. Eligible Dental Expenses

Performance Plus Dental Plan. Annual Deductible. Dental Benefit Maximums. Prior Authorization. Verification of Coverage. Eligible Dental Expenses Performance Plus Dental Plan The Trust provides a Dental Plan for Participants the Performance Plus Dental Plan. In-Network Services are available from dentists contracted on behalf of the Trust. Out-of-Network

More information

Portage La Prairie School Division. Dental Plan

Portage La Prairie School Division. Dental Plan Portage La Prairie School Division Dental Plan Eligibility Dental benefits are available to all regular full-time or part-time teachers signed to a Teacher General Contract, teachers on a Limited Term

More information

DENTAL DENTAL PLAN of North Carolina

DENTAL DENTAL PLAN of North Carolina DENTAL DENTAL PLAN of North Carolina 333 Six Forks Rd Ste 18 Raleigh NC 27609 800-662-8856 http://www.deltadentalnc.org Plan Document Group #1100 This document should be read in conjunction with the Schedule

More information

Quality, affordable dental insurance

Quality, affordable dental insurance Quality, affordable dental insurance Group association dental insurance under the Madison Dental plans is underwritten by Madison National Life Insurance Company, Inc. in all states except New Hampshire

More information

Yale University - Group No. 4630

Yale University - Group No. 4630 Yale University - Group No. 4630 Dental Plan For Faculty, Post-Doctoral Associates & Fellows And Managers & Professional Staff Advancing Solutions For Great Oral Health January 1, 2015 Description of Covered

More information

Dental plans to smile about

Dental plans to smile about Dental plans to smile about Individuals and families Plans available Jan. 1, 2015, through Dec. 31, 2015 Alaska 4 Together, we can find a way to better health. Dental plans Dental coverage for your total

More information

Anthem Blue Dental PPO Plan

Anthem Blue Dental PPO Plan Anthem Blue Dental PPO Plan For Individuals and Families Anthem Blue Cross and Blue Shield 700 Broadway Denver, Colorado 80273 anthem.com An independent licensee of the Blue Cross and Blue Shield Association.

More information

HumanaOne. Optional benefits. Add extra benefits to your medical plan

HumanaOne. Optional benefits. Add extra benefits to your medical plan HumanaOne Optional benefits Add extra benefits to your medical plan Dental Protect your healthy smile with affordable, easy-to-use optional dental benefits from one of the nation s largest dental insurers.

More information

Dental Plans. Montgomery County Public Schools Summary Plan Description

Dental Plans. Montgomery County Public Schools Summary Plan Description Montgomery County Public Schools Summary Plan Description Table of Contents Dental Plans At-A-Glance...2 The Preferred Provider Organization...5 How Benefit Amounts Are Determined...5 Annual Deductibles

More information

SECURITY LIFE INSURANCE COMPANY OF AMERICA Minnetonka, Minnesota

SECURITY LIFE INSURANCE COMPANY OF AMERICA Minnetonka, Minnesota SECURITY LIFE INSURANCE COMPANY OF AMERICA Minnetonka, Minnesota COVERAGE SCHEDULE PREFERRED (In-Network) PROVIDER: WE WILL PAY BASED ON THE CONTRACTED FEE FOR SERVICE WITH THE PREFERRED PROVIDER ORGANIZATION

More information

YOUR SUMMARY PLAN DESCRIPTION

YOUR SUMMARY PLAN DESCRIPTION YOUR SUMMARY PLAN DESCRIPTION NEW YORK UNIVERSITY Classic PDP Plan Dental Benefits for You and Your Dependents Effective: January 1, 2016 YOUR SUMMARRY PLAN DESCRIPTION INTRODUCTION This Summary Plan Description

More information

dental plan For Students 2015-2016 Ameritas Life Insurance Corp. of New York

dental plan For Students 2015-2016 Ameritas Life Insurance Corp. of New York dental plan For Students 2015-2016 Cornell University students and dependents may enroll in an optional dental insurance plan that has been tailored to fit their needs. This plan, offered through Ameritas

More information

Dental Plans. MetLife Dental Plan Delta Dental Plan. ACTIVE UT-B Dental Plans 3 1 1/1/2013

Dental Plans. MetLife Dental Plan Delta Dental Plan. ACTIVE UT-B Dental Plans 3 1 1/1/2013 Dental Plans There are two dental plans to choose from the Metropolitan Life Insurance Plan (MetLife) and the Delta Dental Plan of Ohio (Delta Dental). You may elect either plan, but not both. The dental

More information

EmblemHealth Preferred Dental

EmblemHealth Preferred Dental EmblemHealth Preferred Dental Unique coverage levels at affordable group rates. Here s how EmblemHealth Preferred Dental will deliver for you: Complete your benefits package with paid-infull* in-network

More information

IT S TIME TO ENROLL FOR YOUR BENEFITS

IT S TIME TO ENROLL FOR YOUR BENEFITS IT S TIME TO ENROLL FOR YOUR BENEFITS The Monroe County Bar Association Welcome! It s time to enroll in your benefits for the coming year. The first step in choosing your benefits is to learn the details.

More information

Individual Dental Insurance

Individual Dental Insurance Individual Dental Insurance From Delta Dental of Wisconsin Be your own individual with dental plans from the most trusted name in dental benefits. Plan designs and rates subject to change without notice.

More information

Dental plans to smile about

Dental plans to smile about Dental plans to smile about Individuals and families Plans available Jan. 1, 2015, through Dec. 31, 2015 Oregon Hello. Welcome to Moda Health and ODS, the place you go for great dental care because good

More information

HumanaDental. Regulatory and Technical Information Guide

HumanaDental. Regulatory and Technical Information Guide HumanaDental Regulatory and Technical Information Guide Table of Contents Questions.....................................2 Late Applicant.................................2 Florida...................................2

More information

HERE S TO PEOPLE WHO THINK DENTAL CARE

HERE S TO PEOPLE WHO THINK DENTAL CARE DENTAL PLANS HERE S TO PEOPLE WHO THINK DENTAL CARE GETTING THE DENTAL COVERAGE THATS S RIGHT FOR YOU 2006 2007 Dental Plans A DENTAL PLAN to fit your needs A CHOICE IN PLANS Health Net has a dental plan

More information

DentalEssentials. Dental insurance for individuals and families

DentalEssentials. Dental insurance for individuals and families DentalEssentials Dental insurance for individuals and families Regular dental care is an important part of an overall healthy lifestyle Unfortunately, the cost of dental treatment, coupled with the lack

More information

Final. $2,500 per member $5,000 per family

Final. $2,500 per member $5,000 per family Final PPO PPO Medical, Rx, Dental Core, Dental Buy Up Benefits-at-a-Glance City of Pontiac Group Number: 71489 Deductible, Copays/Coinsurance and Dollar Maximums Deductible - per calendar year Copays/Coinsurance

More information

SMALL GROUP PLANS FOR FAMILIES AND ADULTS WITH COMPREHENSIVE COVERAGE Page 1 of 9 Features & Benefit Details

SMALL GROUP PLANS FOR FAMILIES AND ADULTS WITH COMPREHENSIVE COVERAGE Page 1 of 9 Features & Benefit Details SMALL GROUP PLANS FOR FAMILIES AND ADULTS WITH COMPREHENSIVE COVERAGE Page 1 of 9 PLAN NETWORK Premium range child under age 19* Sample premium range typical family of 4* Is this a smaller network? Is

More information

Plans for Families and Adults with Comprehensive Coverage Features & Benefit Details

Plans for Families and Adults with Comprehensive Coverage Features & Benefit Details Page 1 of 7 s for Families and Adults with Comprehensive Coverage Network Premier Altus Dental Participating Dentists Blue Cross PPO Dental Preferred Dentist Program Plus EPO Family EPO DentalGuard Preferred

More information

Principal PPO Dental Plan

Principal PPO Dental Plan Principal PPO Dental Plan TargetCW is pleased to offer you participation in the Principal Dental Plan. Below is some important information to know about the plan. If you have any questions, please do not

More information

2015 Insurance Benefits Guide. Dental Insurance. Dental Insurance. www.eip.sc.gov S.C. Public Employee Benefit Authority 95

2015 Insurance Benefits Guide. Dental Insurance. Dental Insurance. www.eip.sc.gov S.C. Public Employee Benefit Authority 95 2015 Insurance Benefits Guide www.eip.sc.gov S.C. Public Employee Benefit Authority 95 Insurance Benefits Guide 2015 Table of Contents Introduction...97 State Dental Plan... 97 Dental Plus... 97 Dental

More information

Advancing Solutions For Great Oral Health

Advancing Solutions For Great Oral Health Yale University - Group No. 4630 Dental Plan For Clerical & Technical Service & Maintenance & Yale Police Benevolent Association (YPBA) & Security Staff Advancing Solutions For Great Oral Health January

More information

The Full Dental Plan is designed to cover diagnostic, preventive and restorative procedures necessary for adequate dental health.

The Full Dental Plan is designed to cover diagnostic, preventive and restorative procedures necessary for adequate dental health. Full Dental Plan The Full Dental Plan is designed to cover diagnostic, preventive and restorative procedures necessary for adequate dental health. Covered services include: Oral Examinations Periapical

More information

Dental Benefits. A healthy smile could mean. better health that s why. I need a good dental plan.

Dental Benefits. A healthy smile could mean. better health that s why. I need a good dental plan. Group Dental Dental Benefits Savings, flexibility and service. For healthier smiles. A healthy smile could mean better health that s why I need a good dental plan. Regular visits to the dentist may do

More information

BlueCare Dental OUTLINE OF COVERAGE. For Subscribers Age 21 and Over. Out-of-Network Dentist* Dentist. Out-of-Network Dentist.

BlueCare Dental OUTLINE OF COVERAGE. For Subscribers Age 21 and Over. Out-of-Network Dentist* Dentist. Out-of-Network Dentist. BlueCare Dental OUTLINE OF COVERAGE Read your Contract carefully This outline coverage provides only a very brief description the important features your Contract. This is not the Contract, and only the

More information